Active NPI
Frank Michael Walerko, DDS
- General Practice Dentistry
- Portage, IN
National Provider Identifier
1699802280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 8158
- Practice address
- 6060 Lute Rd
Portage, IN 46368-5008 - Phone
- (219) 762-3842
- Fax
- (219) 764-7406
- NPI assigned
- Feb 28, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 8158 | IN | Primary |
Addresses
Primary practice location
6060 Lute Rd
Portage, IN 46368-5008
Mailing address
6060 Lute Rd
Portage, IN 46368-5008
Phone (219) 762-3842
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160511000103 | IN | Order and Referring Only - Dentist | 6204125586 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8158 | IN | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1699802280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6060 LUTE RD",
"city": "PORTAGE",
"state": "IN",
"postal_code": "463685008",
"telephone_number": "219-762-3842",
"fax_number": "219-764-7406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6060 LUTE RD",
"city": "PORTAGE",
"state": "IN",
"postal_code": "463685008",
"telephone_number": "219-762-3842",
"fax_number": "219-764-7406"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALERKO",
"first_name": "FRANK",
"middle_name": "MICHAEL",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IN",
"license": "8158",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portage, IN
- Vitas Healthcare Corporation Midwest
- Gayle Marie Voight-Block, FNP
- Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2544)
- Wal-Mart Stores East, LP (Vision Center 30-2544)
- Emily Waldo, MS, NCC, LMHC
- Walgreen Co (Walgreens #13949)
- Walgreen Co (Walgreens #04560)
- Megan K Walker
- Kathryn Mary Wallace, APRN, BC
- Cartricia Walters, LSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.